1447483276 NPI number — MR. RAYMOND BEN GOINS CASI

Table of content: MR. RAYMOND BEN GOINS CASI (NPI 1447483276)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447483276 NPI number — MR. RAYMOND BEN GOINS CASI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOINS
Provider First Name:
RAYMOND
Provider Middle Name:
BEN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
CASI
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447483276
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
727 ZION STREET PLAZA
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRASS VALLEY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95959
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-265-2914
Provider Business Mailing Address Fax Number:
530-265-2974

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
727 ZION STREET PLAZA
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRASS VALLEY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95959
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-265-2914
Provider Business Practice Location Address Fax Number:
530-265-2974
Provider Enumeration Date:
08/27/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)